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The headache handbook.

Everyone has a headache at one time or another. For many people, the pounding pain is little more than an annoyance easily relieved with aspirin or acetaminophen. For others, however, the pain can be chronic, severe and debilitating. Yet despite the serious nature of headaches, they are all too frequently misunderstood. They have been the subject of endless jokes, considered to be a psychological not a medical problem, an excuse or plea for attention and, all too frequently, something you have to live with.

The understanding of headaches has advanced greatly over the past decades and new diagnostic techniques and therapies have helped make headaches a problem that many patients no longer have to live with. In most cases, your physician is in the best position to help you understand your headache and inform you about what can be done.

Types of Headaches

Headaches come in many forms, and each type has its own mode of treatment. Identifying the appropriate headache classification can be helpful in terms of eventual diagnosis and developing a treatment program.

Tension: This is by far the most common form of headache, and it is characterized by a dull pain and a feeling of tightness around the scalp or neck. Tension headaches commonly affect the entire head and are not localized to one side. They are often triggered by emotional stress, fatigue or depression.

Cluster: The pain associated with this type of headache is generally very severe, developing around or behind one eye. It usually occurs at night and awakens the victim from sleep. The affected eye may tear and the nose may become congested on the same side as the headache. Attacks occur in clusters, or groups, for days, weeks or months at a time--then they may disappear for a year or more. Most cluster headache sufferers are men, and there's some evidence that excessive smoking and/or alcohol consumption can trigger an attack.

Sinus: When sinuses become infected or inflamed, a gnawing pain may develop in the nasal area, often increasing in severity as the day goes on. One of the most common symptoms of a sinus headache is a rise in temperature. In most instances, nasal decongestants and antibiotics are used to treat sinus headaches, although draining the affected sinus also provides relief.

Temporal Arteritis: This type of headache normally affects older adults and is associated with a low grade fever, problems with eyesight, weight loss and a pain on one side of the jaw while chewing. The headache is caused by an inflammation of the temporal artery resulting in a jabbing, burning pain around the ear. Unfortunately, the cause of the inflammation has not been determined. It is important to seek help because serious complications may develop.

Vascular: A vascular headache occurs when the blood vessels in the scalp expand and contract to produce a throbbing pain, often synchronized with the pulse beat. The best known and probably the most debilitating of the vascular headaches are migraines--the pain of which starts on one side of the head and generally remains one-sided.

Classic and Common Migraine

All migraine headaches are characterized by severe pain and, in many cases, nausea, vomiting, dizziness, cold hands, tremor, sensitivity to light and sound. Attacks are intermittent and may last for a few hours, a full day or even longer.

The difference between "classic" and "common" migraine is that "classic" migraine gives the victim certain warning symptoms from 10 to 30 minutes prior to the onset of the headache. These symptoms, technically known as an "aura," can include visual disturbances such as flashing lights, zigzagging lines or areas of total darkness; tingling or numbness in an arm or leg; strange odors; restlessness; confusion; speech impairment. Soon after the "aura," the headache begins.

Who Gets Migraines?

There appears to be a hereditary component to migraines; 70 to 80 percent of people with migraines have a family history of the ailment. Also, women are three times more likely than men to suffer from this form of headache.

Some studies suggest migraine sufferers are perfectionists, driven to succeed; other studies refute the idea of a so-called "migraine personality." However, scientists agree that how you cope with anger, anxiety and tension can contribute to the onset of a migraine. Learning to relax and alleviate stress may help reduce the severity of an attack.

Changing hormone levels during menstruation and ovulation can also provoke a migraine, as can poor lifestyle habits such as irregular eating and sleeping patterns. What you eat may also affect migraine; there's evidence that ripened cheese, chicken liver, citrus fruits, chocolate, red wines and excessive amounts of caffeine-containing drinks such as cola and coffee can trigger an attack. Other suspect substances are food additives such as monosodium glutamate and preservatives found in smoked and processed meats. Even the odor of perfume, flowers or natural gas can lead to an attack. Migraines may also result from weather and altitude changes.

Migraine Treatment

The first step in treating migraines is to make an appointment with your physician, who can make an accurate diagnosis of your condition. Your physician can also develop a treatment plan which may consist of lifestyle changes plus medication.

There are two basic categories of migraine medicine. One, called abortive, relieves pain and symptoms once an attack has begun; the other, called prophylactic, is a preventive measure that can eliminate attacks completely. Preventive medicine is recommended for patients who are suffering from more than two attacks per month, or finding that attacks are preventing normal activity

In addition to prescribing medicine, your physician will probably advise you to avoid migraine triggers such as severe stress, suspect foods, excessive smoking and alcohol consumption. Keeping a detailed record of your attacks, including times, diet, odors, emotions, onset and duration, will increase your awareness of the factors that contribute to your migraine attacks and help you make the necessary lifestyle changes.

Are You a Migraine Sufferer?

Having an occasional tension headache is one thing; you take a pain reliever and don't think too much more about it. But if you experience any of the following symptoms, your headache may be caused by something other than tension, or can be a warning sign of a more serious disorder.

Consult your physician if your headache...

* is sudden and severe

* affects one side of the head

* is associated with pain in the eye or ear

* is accompanied by nausea, vomiting, hallucinations, sensitivity to light and sound

* recurs in a definite pattern--the time of day, the circumstances and the durations of pain are similar time after time

* results in confusion or loss of consciousness

* is persistent--when previously you've been headache-free

* interferes with your ability to function normally at work or in social situations.

* is similar to headaches suffered by other members of your family

Do any of these describe your symptoms? If so, you may be a migraine suffer. It's a wise idea to see a doctor as soon as possible. The sooner you get your condition diagnosed, the better off you'll be.
COPYRIGHT 1994 National Headache Foundation
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1994 Gale, Cengage Learning. All rights reserved.

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Publication:Pamphlet by: National Headache Foundation
Article Type:Pamphlet
Date:Jan 1, 1994
Words:1168
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